COVID 19 and Anti Inflammatory Drugs

Do not take Ibuprofen.
https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection

@phranny said
Do not take Ibuprofen.
https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection

Thanks for that.

I take 2x75mg sodium diclofenac a day for
arthritis so I will take advice from GP if I get Covid-19.

@wolfgang59 said
Thanks for that.

I take 2x75mg sodium diclofenac a day for
arthritis so I will take advice from GP if I get Covid-19.

Many people who have COVID 19 are asymptomatic. They are shedding the virus with every exhale. Ibuprofen might increase their risk of getting sicker.

@wolfgang59 said
Thanks for that.

I take 2x75mg sodium diclofenac a day for
arthritis so I will take advice from GP if I get Covid-19.

The Guardian article lists ibuprofen and cortisone (which is a steroid and not an NSAID) [1], but not asprin. It's specific drugs already known to reduce immune responses in infections which are potentially problematic. The Wikipedia page does not mention "reduced immune response" as an adverse effect of taking diclofenac [2] - the page on cortisole does mention immune suppression as a benefit in patients with auto-immune diseases and organ transplant patients [3]; but the page on ibuprofen does not mention effects on the immune system [4]. The page on aspirin mentions a theoretical mechanism whereby it increases immune response [5][6]. That diclofenac is an NSAID means there's a question mark, but unless it's known to suppress immune response there's no reason to do anything, especially since aspirin appears to be ok.

Your pharmacist will probably know the answer to this. Given there's a week or so between infection and the onset of symptoms and you are already taking this stuff, waiting until symptoms start is probably a mistake. If you are at all concerned either send your Doctor a message asking the question or ask at a pharmacist.

[1] https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection
[2] https://en.wikipedia.org/wiki/Diclofenac
[3] https://en.wikipedia.org/wiki/Cortisone
[4] https://en.wikipedia.org/wiki/Ibuprofen
[5] https://en.wikipedia.org/wiki/Aspirin#Additional_mechanisms
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2213311/
This is a study in a rat model and is written in biology techno-babble, but it's the basis for the claim in [5] that aspirin may boost immune response.

@DeepThought
https://www.bbc.com/news/51929628

Seems there is a lot of false info out there.
Ibuprofen is almost certainly SAFE.

@wolfgang59 said
@DeepThought
https://www.bbc.com/news/51929628

Seems there is a lot of false info out there.
Ibuprofen is almost certainly SAFE.

Ha, well there you are. However, paracetamol is considered to be the first line analgesic and should be taken in preference to ibuprofen and other NSAIDs anyway. If paracetamol is ineffective then try something else. What ibuprofen is really good for is dental pain and headaches.

Note the following from the article you linked to:

There has been no research into ibuprofen and the new coronavirus (Covid-19).

But there has been some for other respiratory infections, suggesting ibuprofen is linked to more complications and more severe illness - although we don't know that the ibuprofen itself is causing this, according to Paul Little, a professor of primary care research at University of Southampton.

Some experts believe that ibuprofen's anti-inflammatory properties may affect the body's immune response.

Prof Parastou Donyai at the University of Reading says: "There are many studies that suggest ibuprofen use during a respiratory infection can result in worsening of the disease or other complications."

Regarding diclofenac, I did a quick search on PubMed with the search term: "diclofenac immune suppression". There's no indication that diclofenac is a problem except possibly in catfish [1]. I only looked at the first page of results. The studies all seemed to be in animal models. There was a study in mice that indicated that it improved immune response in murine glioma [2]. I also searched for "diclofenac respiratory disease" and again there wasn't anything that leapt out. I tried "diclofenac SARS" and there were no results. I tried "diclofenac coronavirus" and there were no results.

There is no evidence that diclofenac is a problem. There is contradictory low quality evidence about its effect on the immune system in animal models.

[1] https://www.ncbi.nlm.nih.gov/pubmed/28106285
[2] https://www.ncbi.nlm.nih.gov/pubmed/22752934

@Phranny
So the question there is why are they asymptomatic? Is their immune system that much better the virus is getting destroyed? Don't see that happening if they are able to infect others. Are there any studies trying to suss this out?

Typhoid Mary is the classic example. They just have it, but do not show symptoms.

@sonhouse said
@Phranny
So the question there is why are they asymptomatic? Is their immune system that much better the virus is getting destroyed? Don't see that happening if they are able to infect others. Are there any studies trying to suss this out?

https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-us-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX

@joe-shmo
Of course we see lots of these but the burning question is why. Nobody has THAT answer yet.